HomeMy WebLinkAbout1148 STRATBOROUGH LN - SPECIAL INSPECTIONS - 2/8/2012City of CollinsCommunity Development & Neighborhood Services
F6r't lli281 N College Ave; P.O. Box 580; Fort Collins, CO 80522-0580
"- Phone: 970 221 6760 FAX: 970 224 6134
Field Verification Form
Job Site//� U/!z� /U�[>�j G� 1�n/l� Permit No.
Company Name (A 921y L�i�N /✓,(%Lf�//�G4 ��/r�,City of Ft Collins
Replace nt of Sewer line approx. ft. (100 ft. maximum)
aceme ntt of Water line approx. ft. (100 ft. maximum)
Add Replace gas line approx. ft. ( 50 ft. maximum)
Materials used: mod/ V
Tested at ?-,a Lbs. for 3 -,.> minutes
Installer Name
Installer Signat
(print)
ur Date eh/2,-